光子引导的光声流效应在根管荡洗中应用的系统评价  

Systematic review on the effect of photon-initiated photoacoustic streaming in endodontic irrigation

作　　者：何蓉 刘学军[1] 周宇琨 He Rong;Liu Xuejun;Zhou Yukun(Dept.of Special Clinic,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院口腔特诊科,郑州450052

出　　处：《国际口腔医学杂志》2021年第6期644-655,共12页International Journal of Stomatology

摘　　要：目的评价掺铒钇铝石榴石(Er:YAG)激光光子引导的光声流(PIPS)效应在根管荡洗中的作用效果。方法计算机检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、PubMed、Embase、Cochrane Library、Web of Science、SCOPUS数据库,纳入有关PIPS根管荡洗作用的随机对照试验,检索时间从2010年1月至2020年7月,所选文献按照纳入和排除标准进行筛选,根据Cochrane系统评价的方法进行风险评估,根据《系统综述和荟萃分析优先报告的条目:PRISMA声明》确定的项目进行评价。结果最终共纳入45篇文章,通过归类描述和系统评价,这些文章体现了PIPS技术在灭菌、去除玷污层及牙本质碎屑、去除根管内氢氧化钙、增加牙本质小管渗透性等方面有显著的成效,但是仍有部分实验结果未能体现PIPS技术的优势。目前,PIPS技术的研究中存在实验对象(离体牙根管长度和弯曲度的差异)以及实验过程和方法未标准化、研究方法存在差异等问题,缺少根管微裂、根尖溢出冲洗液和碎屑、标准参数、不同根管荡洗方法作用效果的比较、随机对照的临床试验等方面的相关研究。结论大多数实验结果表明PIPS在灭菌、去除玷污层及牙本质碎屑、去除根管内氢氧化钙、增加牙本质小管渗透性等方面有显著的成效,但仍有实验结果存在争议,需要更多长期、大样本、高质量、设计严谨的实验来验证这些结论。Objective This work aims to evaluate the effect of photon-initiated photoacoustic streaming(PIPS)induced by Er:YAG laser activation on root canal irrigation.Methods Randomized controlled trials(RCTs)on the effect of PIPS in root canal irrigation in China were searched using China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal Database,PubMed,Embase,Cochrane Library,Web of Science,SCOPUS.All studies were published between January 2010 and July 2020 and were subsequently screened based on the inclusion and exclusion criteria.Item risk assessment and evaluation were conducted following the method of the Cochrane systematic review and PRISMA Guidelines.Results Forty-five eligible studies were included for description classification and systematic review.Results showed that PIPS has a significant effect on sterilizing;removing the smear layer,dentin debris,and calcium hydroxide from root canals;and increasing the depth of dentin tubule penetration.However,some findings failed to reflect the advantages of PIPS.At present,research on PIPS in terms of subjects(differences in length and curvature of isolated canals)remains lacking.The procedures and methods are not standardized,thus leading to differences in the research methods.Studies on root canal micro-fractures,irrigation solution and debris squeezed from apical foramen,standard parameters,comparison of various methods of irrigation,and randomized controlled clinical trials are also lacking.Conclusion Most studies showed that the PIPS of Er:YAG has significant effects on removing the bacteria,smear layer,dentin debris,and calcium hydroxide of root canals and increasing the depth of dentin tubule penetration.However,some results are controversial.This conclusion requires long-term,high-quality,and welldesigned RCTs with large sample sizes for further validation.

关 键 词：掺铒钇铝石榴石激光 光子引导的光声流 根管治疗 根管清创 细菌 玷污层 牙本质小管渗透 微裂 

分 类 号：R781.33[医药卫生—口腔医学]